HomeMy WebLinkAboutBuilding Permit 14. 0590 J
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ooiPRiCITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
t. TEMPORARY CERTIFICATE OF ZONING COMPLIANCE r ,
m( AND UTILITY CONNECTION PERMIT 0 `.)O O. 7
44NEWP I. White FCity PERMIT NO. (4•.� •
2. Pink Cit ``'"'�C
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
3630 Toin-ft, Paz NV -Prior La,k 11110 5C31-2-
LEGAL DESCRIPTION(office use only)
LOTS BLOCK/ ADDITION .J el (orsLi 5" 4t/ PID
00001411 , ,OWNER /�/� ] / -01 Aar %j
(Name) ce a Y'\. V 1 . H) 1,Gt ra 1''k et (Phone)
(Address)
BUILDER - A
(Company Name) - (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK 0 New Construction ['Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish El Fireplace
['Addition ['Alterao ❑Utility Connection
CODE;ALC. ❑I.B.C. ❑Misc.
Type of on etion: I II III IV V A B PROJECT COST/VALUE $
Occupancy Group: ABE F HI MR SU (excluding land)
Division: 1 2 3 4 5
1 I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the
above-mentioned property and that all constru tion will conform to all existing st to and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can a this permit for,ust cause Ft ther- .r. I he,..y agree th.�the., official or a designee may enter upon the property to perform needed inspections.
1
1 X ""�. $1., / I%
Signature Contractor's License No. Date
Permit Valuation3°619..' Park Support Fee # $
Permit Fee $ fee 26— SAC # $
Plan Check Fee $ 5-7-3 Water Meter Size 5/8"; 1"; $
State Surcharge $
/r t 5 Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ l f 1 .1 1
/ '
This • l is ,on Becomes Your Building Permit n Appr ved7'94M 7 1t/3:1 f Receipt No. ' l1
41 Lyme By 5 C -
Date
This is to c• that e request in thNbove application and accompanying documents i•in accordan with the City Zoning Ordinance and may proceed as requested. This document
when sign/
, f the, Planner constitutes a temporary Certificate of Zoning complian e and allow construction to commence. Before occupancy,a Certificate of Occupancy must be
issued. r
_ , li ate Special Conditions,if any
24 hour notice for all inspections(9.2)447-9850,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372
III